Application Process for Veteran Affairs Canada (VAC) PTSD and other Mental Health Disabilities

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1 Application Process for Veteran Affairs Canada (VAC) PTSD and other Mental Health Disabilities When you submit an application for disability compensation and one of the disabilities you are claiming for is Post-Traumatic Stress Disorder (PTSD), a statement should be submitted with your application describing the stressful experiences you had in the Force that led to your developing PTSD or another mental disability. You will be supplied with a Statement in Support of Claim form where you can write down your statement. You can add additional information by attaching it to your application. If you believe that you have a work-related disability call (TO DAY!!!!) and make an application for your disability(s). When prompted, hit 1 which will take you to a VAC representative. This will be the date of record for your disability application. Prepare to Write Your Statement It is difficult to sit down and write about terrible events that you don t even want to think about or remember. You may want to discuss things with a supportive person before you sit down to write and then after you have finished it. This can help you to feel less isolated with your memories. It is OK to say what parts of your experiences you can t remember. Most people can t remember everything about a traumatic event because the body goes into shock and processes information in a different way than during non-stressful times. Records to Have Available It will help to have your medical, personnel and service files and records of your own communications to help jog your memory. You can request a copy of these records through Access to Information, form RCMP GRC 6330e Mail your completed request to the following address: Royal Canadian Mounted Police Access to Information and Privacy Coordinator 73 Leikin Dr. Mail Stop 061 Ottawa, ONK1A 0R2 These records may help you remember dates and other details of what happened. However, do not wait for these files to arrive before you submit your disability application. Veterans Affairs Canada will also have access to your medical file and they will review the file as part of their review process. Include on each form your Regimental number. You must complete a separate form (RCMP GRC 6330e ) for each file requested but all three request documents can be mailed in the same envelope. You do not need to send any money for this service. How to Write Your Statement Write very clearly, or type on a computer if you can. Describe the traumatic events in the order that they happened. Tell where the event happened, what unit you were in at the time, and when it happened (as best you can). Provide as much detail as you can and also describe the feelings you had about what happened. Don t diminish the stressful experience you had and don t make it seem even more severe than it was. Just tell exactly what occurred and that will be very effective. Describe How You Have Changed Next, describe what your life was like before your injury in the RCMP or what your relationship with friends and families was like before the injury, whether you played sports on a Force team in a police community based function etc. Then describe how you have changed during your service. Give examples of problems you had in your service, and how relationships changed. Describe your difficulty adjusting to civilian life or, if you are still serving, how it has affected you and your present work. If you are no longer interested in activities you once enjoyed, talk about that. Give specific examples of your PTSD symptoms. For example, I had a panic attack when I heard a car backfire, I thought it was gunfire or I heard someone scream on TV and I ran for cover. This will be much more effective than providing clinical descriptions of 1

2 symptoms that you may have learned while undergoing mental health treatment. Describe investigations you were involved in and how that now affects you. Issues with supervisors and co works also may have caused your condition; if that is the case, describe those situations. Talk about what help you have received for this condition to date or your attempts to have your concerns recognized. Post-Traumatic Stress Disorder (PTSD) is a medical condition that can develop after experiencing a terrifying event or an accumulation of events. Some of the common symptoms of PTSD include: persistent memories of the event, nightmares, re-living the event over and over not talking to anyone about the event, avoiding any situation that may trigger your bad memories feeling numb and detached, depressed, disinterested in normal life activities, and feeling on high alert all the time, always watching for danger. The diagnostic criteria are specified below. Diagnostic criteria for PTSD include a history of exposure to a traumatic event that meets specific stipulations and symptoms from each of four symptom clusters: intrusion, avoidance, negative alterations in cognitions and mood, and alterations in arousal and reactivity. The sixth criterion concerns duration of symptoms; the seventh assesses functioning; and, the eighth criterion clarifies symptoms as not attributable to a substance or co-occurring medical condition. Reference following: American Psychiatric Association. (2013) Diagnostic and statistical manual of mental disorders, (5th ed.). Washington, DC: Author. Criterion A: stressor The person was exposed to: death, threatened death, actual or threatened serious injury, or actual or threatened sexual violence, as follows: (one required) 1. Direct exposure. 2. Witnessing, in person. 3. Indirectly, by learning that a close relative or close friend was exposed to trauma. If the event involved actual or threatened death, it must have been violent or accidental. 4. Repeated or extreme indirect exposure to aversive details of the event(s), usually in the course of professional duties (e.g., first responders, collecting body parts; professionals repeatedly exposed to details of child abuse). This does not include indirect non-professional exposure through electronic media, television, movies, or pictures. Criterion B: intrusion symptoms The traumatic event is persistently re-experienced in the following way(s): (one required) 1. Recurrent, involuntary, and intrusive memories. Note: Children older than six may express this symptom in repetitive play. 2. Traumatic nightmares. Dissociative reactions (e.g., flashbacks) which may occur on a continuum from brief episodes to complete loss of consciousness. 3. Intense or prolonged distress after exposure to traumatic reminders. 4. Marked physiologic reactivity after exposure to trauma-related stimuli. Criterion C: avoidance Persistent effortful avoidance of distressing trauma-related stimuli after the event: (one required) 1. Trauma-related thoughts or feelings. 2. Trauma-related external reminders (e.g., people, places, conversations, activities, objects, or situations). 2

3 Criterion D: negative alterations in cognitions and mood Negative alterations in cognitions and mood that began or worsened after the traumatic event: (two required) 1. Inability to recall key features of the traumatic event (usually dissociative amnesia; not due to head injury, alcohol, or drugs). 2. Persistent (and often distorted) negative beliefs and expectations about oneself or the world (e.g., "I am bad," "The world is completely dangerous"). 3. Persistent distorted blame of self or others for causing the traumatic event or for resulting consequences. 4. Persistent negative trauma-related emotions (e.g., fear, horror, anger, guilt, or shame). 5. Markedly diminished interest in (pre-traumatic) significant activities. 6. Feeling alienated from others (e.g., detachment or estrangement). 7. Constricted affect: persistent inability to experience positive emotions. Criterion E: alterations in arousal and reactivity Trauma-related alterations in arousal and reactivity that began or worsened after the traumatic event: (two required) 1. Irritable or aggressive behavior 2. Self-destructive or reckless behavior 3. Hypervigilance 4. Exaggerated startle response 5. Problems in concentration 6. Sleep disturbance Criterion F: duration Persistence of symptoms (in Criteria B, C, D, and E) for more than one month. Criterion G: functional significance Significant symptom-related distress or functional impairment (e.g., social, occupational). Criterion H: exclusion Disturbance is not due to medication, substance use, or other illness. Specify if: With dissociative symptoms. In addition to meeting criteria for diagnosis, an individual experiences high levels of either of the following in reaction to trauma-related stimuli: 1. Depersonalization: experience of being an outside observer of or detached from oneself (e.g., feeling as if "this is not happening to me" or one were in a dream). 2. Derealization: experience of unreality, distance, or distortion (e.g., "things are not real"). Specify if: With delayed expression. Full diagnosis is not met until at least six months after the trauma(s), although onset of symptoms may occur immediately. Identifying Post-Traumatic Stress Disorder If you have any of these symptoms, it is worthwhile to visit a mental health professional to determine if you are suffering from PTSD. 3

4 Alcohol, Drug Use and Gambling If you've used alcohol, drugs and gambling to cope with your PTSD symptoms, it s OK to write about that. This is your chance to explain that you couldn t handle having PTSD and that your alcohol, drug use or gambling began, or worsened, after the stressful events occurred. You can also talk about whether you are now clean and sober and how long you have been in treatment, if applicable. If you still use alcohol, drugs and have a gambling problem, talk about why you do so, and how you are coping. Again, this can be evidence of the impact PTSD is having on your life. Finally, write about how you are now feeling about your present life, whether you are in treatment for PTSD, and if you aren t, why not. Sign your statement, and if there are several pages, add page numbers and staple the packet together. Tips on writing an effective statement to VAC A well-written statement is a very powerful tool. While you don't need the skills of an English teacher to write an effective statement, here are a few things you shouldn't do, as well as those you must do. Although the computer age was to rid our offices of paper, it seems to have just given everyone their own printer along with reams of paper. So, your statements to the point. Here are a few more tips: Use italics, boldface and large font sizes sparingly. Keep your message factual. Make reference numbers and dates clearly visible. In response letters, clearly reference and quote from the original message. Never use colored fonts. Never type IN ALL CAPS to emphasize your points. Use plain white sheet paper of a medium grade quality. Remember: Your message on that piece of paper becomes a legal document. If your case should go into a lengthy appeals process, the document you write today may be read again in a court room several years later. Your statement establishes the tone of who you are and your level of professionalism. You may not be appearing in front of the person who will read your communication. So, this statement is your opportunity: 1. to ensure you have provided the evidence required by VAC to render a decision. 2. by ensuring the application is complete and the statement is explanatory. State facts that are relevant to your case. The VAC reader cannot respond to or consider your personal theories of how unfair VAC is to veterans. It is not VAC's job to listen to how you may have fallen on hard times. Your insults toward VAC will be ignored. (NOTE: VAC decisions are evidence based as in accordance with authorizing legislation and policies.) We believe that most VAC Service Representatives will do their best to allow a veteran a little leeway if he or she is angry and needs to blow off a little steam. However, a steady stream of insults is just a waste of everyone's time. Also, these people are human. Wouldn't insults have a negative affect on you, if you were the decision maker? If you feel compelled to write such material in your statement, do so. Then throw it away. Then set about the task of writing a statement that will help you communicate with VAC effectively. Requesting Statements from Family Members, Friends and Coworkers Ask friends, family members and co-workers for a statement detailing how you have changed or things they have noticed while you were in the Force or changes in your behaviour following your retirement. If co-workers, family or friends keep a diary or notes, it can be helpful to refer to it. Your friends, family members and co-workers have a special ability to describe how your life has changed as a result of your injury while in the Force. They may be able to write about the person you were when you entered the Force and the changed person you have become. 4

5 Each person will need to describe their relationship to you, how long they have known you. They should be as honest as possible and just let the facts about your injury speak for themselves. These statements are only useful as evidence in support of your claim and irrelevant information should not be included. Make sure they sign the statement and include their full name and address. Direct Service Connection for Injury In May 2015, the Federal Court of Appeal delivered a judgement in COLE vs Attorney General of Canada (2015 FCA 119). That decision very clearly laid out a four-step process that members must satisfy to establish entitlement to a disability pension under paragraph 21(2)(a) of the Pension Act. They are: 1) Step one requires the applicant to demonstrate that he or she has a claimed condition an injury or disease, or an aggravation thereof. 2) Step two requires the applicant to demonstrate that the claimed condition arose out of or was directly connected with his or her service as a member of the forces. 3) Step three requires the applicant to establish that he or she suffers from a disability. 4) Step four requires the applicant to establish that his or her disability resulted from a RCMP service-related claimed condition. Failure to establish any one of these four steps could be fatal to your application. If you can provide evidence/documentation to establish these four steps, you will be successful in your application. Here s what this means for you: When you are filing a disability claim, it s important to research the condition you are currently applying for, so that you understand the wording that VAC uses for certain disabilities. You could or should find the wording pertaining to your disability by visiting VAC Web site: the Entitlement Eligibility Guidelines and the Table of Disabilities. Then, find the appropriate wording that VAC follows in assigning disability. Go through your medical records to see what you were diagnosed with during your service. You may gather evidence from your family doctor or outside sources if you were treated by a professional outside RCMP Heath Services. Bear in mind RCMP health records are of very poor quality and lots of information about injuries is simply not there. Another great source of reliable confirmation are members or ex members who recall incidents that lead to your disability. Once you get all this information gathered, craft your statement. Remember, in order to get a service-connection the condition must be a current problem. Generally, it must also have occurred or have been aggravated while on duty or acting as a member of the RCMP. It is important to use the right key words and to use them in your statement. VAC Disability - Gather and submit evidence What kind of evidence do I need? Proof of identity is required for new clients; it is not necessary to validate the identity of existing clients unless a risk is identified What is an acceptable proof of identity? Driver s license (provincial) Provincial health care card ( * Excluding Alberta and Manitoba) Other provincial identification card Other federal identification card Certificate of Indian Status 5

6 Vital statistics documents: birth certificate, marriage certificate Employee identification card (Federal, provincial or municipal) Canadian passport Department of National Defense (DND) Casualty Notification Veterans Affairs Canada [VAC] is charged with evaluating your evidence to determine that the claimed condition is related to your service as required by the legislation. Once the claimed condition is determined to be service related, VAC assesses the extent of your disability and provides an assessment rating. You want to offer them the best possible evidence. VAC is looking for clear documentation of: 1. a confirmed diagnosis by a qualified medical professional 2. an event that occurred that had an impact on your health which caused or aggravated your claimed condition, 3. the circumstances surrounding the event to assist in making the service relationship, 4. subsequent treatment records of how the injury or illness was addressed at the time, and 5. any follow-up care or treatment. This evidence will be given significant consideration and weight. Almost anything can be submitted as supporting evidence. Photographs, maps, letters to loved ones and recordings have all been considered as evidence to document events. Search through your notebooks for details of dates and names of those who were with you at the time of the incident or personal files you may have retained. Prepare copies of these, as well as newspaper clippings or photographs that describe the event. To ensure that all critical records reach VAC, you must accept the task of retrieving and documenting. Remember, this is your case. Leaving this task to VAC is a mistake that may cost a great deal later. Then read these final tips: Reference numbers: your VAC-File number, if you have one. When you're replying to a letter from VAC, they will often tell you to use a file number when replying, so insert that, too. State your case as briefly as possible. Be courteous, to the point. Make your statement simple to read and factual. Making demands, criticisms, telling your life story or otherwise straying from a professional tone will slow down the process. You should organize yourself no differently then when you were conducting an investigation while in the Force. Open a separate file on each condition you are applying for and retain copies of all correspondence forwarded or received. Make notes on any phone calls or contacts you have regarding your application. If you have three applications, then you should have three separate files. This process will assist you from becoming overwhelmed and keep you focused on each application. VAC disability entitlement decisions are evidence based decisions made in accordance with authorizing legislation and policies. More specifically, RCMP decisions are made in accordance with the RCMP Superannuation Act/ RCMP Continuation Act in accordance with the Pension Act and the related policies. A well put together disability application package that includes a descriptive and well-informed applicant s statement is very helpful to VAC in making these decisions. References 1. American Psychiatric Association. (2013) Diagnostic and statistical manual of mental disorders, (5th ed.). Washington, DC: Author. 6